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The need for revascularization procedures will remain the same or increase in the next decade
1Cardiovascular Risk Reduction Clinic, University of Alberta, Edmonton. vlad@tachy.uah.ualberta.ca
The Canadian Journal of Cardiology
|May 22, 1998
Summary
Despite advances in cardiovascular risk reduction, the need for coronary revascularization procedures is unlikely to decrease due to an aging population, underused therapies, expanding indications, and a rising epidemic in developing nations.
Area of Science:
- Cardiology
- Public Health
- Health Economics
Background:
- Cardiovascular risk reduction strategies, including lipid-lowering drug therapy, were expected to decrease the need for coronary revascularization.
- However, several factors suggest this decrease is unlikely to materialize in the coming decade.
Purpose of the Study:
- To analyze the factors influencing the future demand for coronary revascularization procedures.
- To evaluate the impact of demographic shifts, treatment adherence, and evolving medical indications on revascularization needs.
Main Methods:
- Analysis of population demographics and aging trends.
- Review of current utilization rates of cardiovascular risk-reduction therapies.
- Examination of emerging evidence and expanding indications for percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG).
- Assessment of the global burden of coronary artery disease, particularly in developing countries.
Main Results:
- Canada's aging population, especially the 'baby boomer' cohort, will increase demand for cardiovascular services.
- Underutilization of proven therapies like lipid-lowering drugs persists due to physician and patient-related barriers.
- Expanding indications for direct percutaneous coronary intervention (PCI) in acute myocardial infarction and cardiogenic shock, and for PCI of totally occluded arteries, will increase procedure volume.
- The coronary artery disease epidemic is emerging in developing countries (e.g., India, China), shifting disease burden and significantly increasing global demand for revascularization.
Conclusions:
- The need for coronary revascularization procedures is projected to rise significantly, both nationally and globally.
- Demographic changes, suboptimal treatment adherence, evolving indications, and the global spread of coronary artery disease will drive increased demand.
- Current risk-reduction strategies alone are insufficient to offset the rising need for revascularization procedures.